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Monday, March 25, 2013

18F-FDG Highly Specific in Malignant Pleural Effusions

BACKGROUND: malignant pleural effusions are common in oncology patients and of great clinical significance. 18F-fluorodeoxyglucose PET/CT is useful in the evaluation and detection of primary and metastatic tumors, but its precise value in malignant pleural effusions is not well known.

METHODS: 50 patients with cancer and a pleural effusion were studied. 18F-FDG PET/CT findings were correlated with cytopathology.

RESULTS: The SUV in malignant effusions were about twice as high as benign ones (3.7 vs 1.7). When using a cutoff SUV of 2.2, there were 12 positive PET/CT studies and 38 negative ones. The sensitivity was 53% and specificity was 91%. For patients with non-small cell lung cancer (n = 24), the sensitivity was 83% and specificity 89%.

CONCLUSION: 18F-FDG PET/CT has reasonable specificity in the evaluation of malignant pleural effusion when using a cutoff SUV of 2.2

COMMENT: This study provides a suggested cutoff SUV to maximize overall accuracy, however, it probably is better to utilize a higher cutoff SUV in order to maximize specificity, ideally to 100%.